Health Insurance: Overview

Seven Paths to Health Insurance

Alex Maiolo

Friday, March 10, 2006

Are you a musician without health insurance? You’re not alone. As musicians ourselves we know there are significant hurdles to obtaining health insurance, especially if you’re trying to make a career as a musician. In 2002 we conducted an online survey to ask musicians about health insurance. Of the 2,700 folks who answered the survey, 44 percent did NOT have health insurance. This is much higher than the national average of the uninsured, which hovers around 18 percent. Of the folks who did not have health insurance, 76 percent said that they couldn’t afford it, while the remainder were split between confusion about plans and where to start, and feeling it was a waste of money.

It’s true, health insurance is expensive, even more so if you’re a certain age, a smoker, or are living in certain parts of the country. And while it may feel like a waste of money, insurance is invaluable in protecting you from financial misery brought on by an accident or a major medical issue.

There are no magic answers to the cost problem – and it gets worse every year – but we do hope that HINT can help musicians overcome some of the hurdles that make getting health insurance such a difficult task by a) explaining the essential parts of health insurance and b) giving musicians access to advice about where to start the process of obtaining insurance.

Let’s start with a review of seven paths to health insurance that musicians could pursue in the US. Click on the links in each section for related articles.

If you are employed, make sure you’re not missing out on an employer-sponsored plan. Or if you are married, are you able to get on your spouse’s plan?
Working for Widgets, Inc. might not be your end goal, but one of the advantages of working in the corporate world is the benefits offered by larger employers. Before you explore these other routes, make sure you are not missing out on any benefits offered by your current employer or, if you’re married, your spouse’s employer. Given the advantages of group coverage (including guaranteed coverage – even for folks with pre-existing conditions) it is important to review these options with your company’s Human Resources representatives before you go one step further.

If you’re about to purchase individual coverage, know what you’re looking for.
If you’re about to purchase individual health insurance coverage, do some thorough research into the range of options, and evaluate your own needs and priorities. Would you like to guarantee that you’d be covered in the event of a catastrophe? Are you able to pay more per month in order to have a lower deductible? Read the articles below to understand the most important components of health insurance plans.

If you’re signed to a major label, you may already be eligible for coverage
If you’re in a band that’s signed a contract with one of the three major labels, you may already be eligible for coverage. In a September 2003 agreement brokered between the major labels and AFTRA, the nation’s major record labels agreed for the first time to make health benefits available for all artists on their rosters.

If you’re on another label, buy your own coverage but ask your label representative about getting reimbursed fully for this cost. Although the AFTRA Code signatories includes all major labels and nearly 1,200 subsidiaries, there are many large independent labels that are not signatories to that agreement. If you’re signed to one of these labels, there are other options you can pursue, especially during the initial contract negotiation process.

If the label does not have a specific health insurance plan for its artists, urge your attorney to discuss adding a clause in your contract that will allow you/your band to purchase and administer your own plan, with full reimbursement from your label for the monthly premium costs.

Both the label and the artists benefit when artists under contract have health insurance – musicians are able to schedule checkups and avert major crises or get emergency assistance, which makes it more likely they’ll be able to continue creating and performing. Talk to your label representative and your attorney, explaining that you’ll administer and pay for your own plan each month, with the expectation that the label would fully reimburse you for this cost on a regular basis.

Understand the benefits of incorporating your band
Whether you’re signed to a label or not, consider incorporating your band and treat it as a small business. This action may lead to a number of tax and business benefits. As an added bonus, you can look into the small business group insurance plans that many insurance providers offer, as opposed to the more expensive option of individual plans for each band member. With a small business group plan, the monthly premium can either be paid by the band itself (if your band is generating that much revenue) or each band member can chip in to cover her/his share of the premium each month. Talk to your tax accountant or manager before pursuing this option to see if it’s right for your band.

Know about the plans or resources offered by the musicians’ unions, PROs and other music advocacy groups
Both of the music unions – AFM and AFTRA – offer insurance benefits to their members. If you are a member of these unions, or work in a field where you participate in union-related work, make sure you know about these plans.

AFTRA: The AFTRA Health and Retirement Fund offers its members two health plans: an Individual Health Plan and a Family Health Plan. Both plans include hospital, major medical, prescription drug, mental health and chemical dependency, wellness and dental programs. In addition, both plans provide members, but not dependents, with life insurance, accidental death and dismemberment (AD&D) insurance and loss of voice.

Qualifying for these benefits can be tough. AFTRA members must have earned at least $10,000 but less than $30,000 in four consecutive calendar quarters or less for union gigs – work done for an employer who’s signed onto a collective bargaining agreement that provides for contributions to the AFTRA Health Fund. However, as noted here, this minimum earnings qualification can be met through major label payments if you are an artist under exclusive contract. There’s a lot more information about their plan on this website. http://www.aftrahr.com/

ASCAP, BMI and SESAC: All three US performance rights organizations list health insurance benefits as one of the advantages of joining. All three point to MusicPro Insurance as a way for musicians to insure their instruments, as well as gain access to health insurance. MusicPro Insurance is not an actual health insurance broker. Instead, MusicPro guides users towards the eHealthInsurance.com for quotes from an array of individual or small group plans. Be aware that you don’t need to be a member of ASCAP, BMI or SESAC to access the eHealthInsurance.com quoting network.

Understand what’s available to you in your state/city.
Many states offer health insurance coverage for low income residents, children, seniors, people with disabilities and veterans. Because the options vary widely from state to state, we urge to you visit these two websites for more information:

Artists Health Insurance Resource Center: Created by the nonprofit Actors’ Fund, this is an extremely comprehensive, state-by-state research tool for individual artists and small business groups looking for health insurance. Includes information on state-funded programs, Medicare/Medicaid, and tips for self-employed and small businesses.

The State Insurance Gateway: This site provides links to each state’s insurance department. This resource is part of Insure.com, a comprehensive, consumer-oriented information source for all types of insurance.

Health Alliance for Austin Musicians provides access to affordable health care for Austin, TX’s uninsured musicians, focusing on prevention and wellness. If you are an uninsured, professional musician in the Austin, TX area, you may be eligible for low-cost primary health care services, basic dental care and mental health counseling provided by HAAM.

SIMS Foundation is a non-profit organization that provides access to low-cost mental health services for Austin, TX musicians and their immediate families. SIMS is dedicated entirely to musicians’ assistance. Named in loving memory of Sims Ellison, the SIMS Foundation was founded to prevent suicides in the Austin music community.

Where to Turn if You’re in Serious Straights
In addition to health insurance plans, you should also know about two charity organizations set up to help musicians in crisis.

MusiCares Foundation: Operated by the Recording Academy, the Musicares Foundation ensures that music people have a place to turn in times of financial, medical or personal crisis. Its Emergency Financial Assistance program offers financial assistance for medical expenses including doctor, dental and hospital bills, prescriptions, addiction recovery treatment, psychotherapy, treatment for HIV/AIDS, Parkinson’s, Alzheimer’s and other critical illnesses, as well as basic living expenses such as rent and utilities. It also offers Addiction Recovery Programs that offers financial and support group assistance for artists and crew struggling with addiction issues.

Sweet Relief: Founded by singer/songwriter Victoria Williams who is battling multiple sclerosis, Sweet Relief is a charity organization that provides financial assistance to all types of career musicians who are facing illness, disability, or age-related problems. Sweet Relief provides financial assistance to musicians of all kinds for medical expenses, alternative therapies, treatment for alcohol or chemical dependency, prescriptions, and living expenses if the artist is unable to work. Sweet Relief also has a new financial assistance program especially for retired or semi-retired older musicians, which helps pay living expenses.

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